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Background: Study was to evaluate the relationship between umbilical coiling index (UCI) and hypo-and hyper coiling of the umbilical cord and parity, neonatal weight, Ponderal Index (PI), APGAR (Appearance, pulse, grimace, activity, and respiration) score, meconium staining of the amniotic fluid, Intrauterine growth restriction (IUGR), hypertensive disorders of pregnancy and delivery interventions.Method: A prospective analytical study was performed from January 2017 to December 2018. Total of 300 patients giving birth at labour room of SCB Medical College, Cuttack were taken into study. Immediately following delivery, the umbilical cord was clamped at the foetal end and cut with scissors. UCI, mode of delivery and perinatal outcome was followed up.Results: There were 149 lower segment caesarean sections accounting to 49.7% and 151 vaginal deliveries including instrumental deliveries which was accounting to 50.3%. Minimum number of coils observed was 2. The maximum number of coils observed was 50. Caesarean section was more in hypo coiling group. APGAR score at 5 min was calculated and there was a total of 109 neonates who had APGAR <7 at 5 minutes (36.33%) out of which there were 17 neonates with hypo coiling (2.33%), 77 neonates with normo-coiling (25.66%) and 15 neonates with hyper coiling (5%). Meconium staining and instrumental delivery was more associated with hyper coiling.Conclusion: Both hyper-coiling and hypo-coiling had significant correlation with adverse perinatal outcome. If the UCI can be measured reliably in utero by ultrasound, then it might be a promising prognostic marker for adverse pregnancy outcome.
ABSTRACT
Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.
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Background: Meconium staining of amniotic fluid has for long been considered to be a bad predictor of the fetal outcome because of its direct correlation of fetal distress, and increased the likelihood of inhalation of meconium, resultant deleterious effects on the neonatal lung. To evaluate etiological factors and severity of MAS in the study group.Methods: This study was done in the Neonatal intensive care unit of the Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital Salem, Tamil Nadu, India in the year 2018. Complete maternal and neonatal details were recorded in to the proforma. Delivery details, resuscitation did were also recorded.Results: In present study, fetal distress was found to be the most common (42.5%) factor associated with MAS followed by PIH (21.6%) and PROM (17%). 22 (9.1%) cases were associated with Postdatism, 18 (7.5%) cases were associated with placental insufficiency. 88 babies had fetal distress (36.6%) prior to delivery. 138 babies had no fetal distress (57.5%).Conclusions: MAS is known to cause severe respiratory distress and Downe's score ranging between 4-8, usually a few hours after the onset of respiratory distress. Nearly 73.3% of the cases with MAS had birth asphyxia, out of which 30% had severe birth asphyxia. This indicates that passage of meconium can occur in utero, often considered a feature of the stressed fetus. Undoubtedly aspiration had occurred before delivery in these babies.
ABSTRACT
Background: In pregnancy amniotic fluid surrounds the foetus and plays an important role in the development of fetus. From the very beginning of the formation of the extracoelomic cavity amniotic fluid can be detected. To evaluate the predictive value of amniotic fluid index (AFI) (<5) for adverse perinatal outcome in terms of cesarean section for fetal distress, birth weight, meconium staining, Apgar scores, and NICU admission at birth.Methods: This was a prospective study of 100 antenatal women visited RMC, Ajmer, Rajasthan, India during the year 2018 with gestational age >34 weeks. The women’s history, clinical examination recorded, and AFI were measured and the perinatal outcome was compared between two groups, i.e., AFI <5 and >5.Results: The cesarean section rate for fetal distress, low birth weight babies, <2.5 kg and meconium staining was higher in patients with oligohydramnios (p=0.012, 0.001, 0.00015 respectively). There was no significant difference in Apgar score at 5 min <7 (p=0.087) and NICU at birth between the two groups.Conclusions: Oligohydramnios has a significant correlation with cesarean section for fetal distress, low birth weight babies and NICU admission.
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PURPOSE: The purpose of this study was to compare the obstetric and perinatal outcome between two groups with or without meconium staining of amniotic fluid (MSAF) at term birth in one-year consecutive population at our delivery unit. METHODS: Pregnancy complication including nonreassuring fetal heart rate pattern, intrauterine growth retardation, oligohydramnios, hydramnios and preeclampsia between the two groups were retrospectively documented by review of medical record. To evaluate the perinatal outcome, apgar score at 1min and 5min, and umbilical artery blood gas analysis were also analyzed. Student T test and chi square test were used for statistic analysis. RESULTS: The study population consisted of 687 full-term neonates with presence (n=89) and absence (n=598) of MSAF. Gestational age at delivery was significantly higher in the MSAF group (p12.0 mEq/L) was not increased. The incidence of non reassuring fetal heart rate pattern was also increased in the MSAF group (4.5% vs 1.0%, p=0.03). However there was no significant difference in 1 min and 5 min Apgar score. CONCLUSION: Although MSAF is associated with the risk of non reassuring fetal heart rate pattern and fetal acidemia, the metabolic acidemia and low apgar score at 5minutes was not significantly increased compared with clear amniotic fluid group. Delivery of pregnancy with MSAF should be managed under the careful fetal heart rate monitoring.